John Urschel has a nuanced view of brain damage in the NFL

Posted by Michael David Smith on September 13, 2017, 1:18 PM EDT

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Ravens offensive lineman John Urschel abruptly retired after research paper published finding that 110 of 111 brains of NFL players studied had the degenerative brain disease CTE. Given that Urschel, an MIT Ph.D. student, is more qualified to assess such research than any other player in the NFL, many saw his retirement as a sign that a player who really understands the risks will decide that playing in the NFL is not worth it.

Urschel says it’s not that simple.

In a lengthy interview for the Freakonomics podcast, Urschel said he doesn’t believe the headlines that came out of that study, suggesting that 99 percent of NFL players get CTE.

“The big headline is, 99 percent of NFL brains they looked at had CTE,” Urschel said. “To NFL players that ask me my opinions about it, I said, ‘Listen, do not look at this like, 99 percent chance that I have CTE.’ Because that is far from what this is saying.”

In fact, Dr. Ann McKee, a neuropathologist who has studied NFL players’ brains, said exactly that: According to McKee, “that number became larger than life.” It’s not accurate to say that because more than 99 percent of players’ brains in this study had CTE, that means more than 99 percent of all players will develop CTE. As Urschel explains, the players whose brains are studied are volunteers — and most people who volunteer their brains to be studied do so because they’re experiencing what they believe are symptoms of brain damage. That’s referred to as selection bias, and it’s a major problem with research studies like the ones that have been conducted on NFL players’ brains.

“There’s a strong, strong case of self-selection bias there. And that cannot be ignored,” Urschel said. “I can’t say that I know for certain that it’s self-selection bias, but my instincts tell me that it’s extremely, extremely likely that it is.”

At the same time, Urschel acknowledged that while he doesn’t believe 99 percent of NFL players develop CTE, he did hear about the study and immediately begin to question if it was time for him to retire.

“This thing comes out, and obviously it’s not 99 percent. It’s 99 percent in the study, but is my chance 99 percent? I highly, highly doubt it. Is it 0 percent? I highly, highly doubt it,” Urschel said. “But the biggest thing it did was, it made me say, ‘I should probably think about this again.’ Not like, ‘OK, this new evidence is extremely overwhelming to change my opinion,’ it’s more like, ‘This really brings something to my attention in a really real way, that I was more or less aware of but attempting to ignore to a degree.’ In the back of my head I had already been having these thoughts.”

As he had those thoughts, Urschel consulted with both his mother and his fiancée, and they both supported him retiring. His father, on the other hand, would have liked to see him continue his NFL career. Ultimately, Urschel decided to quit, thinking about the time he suffered a concussion and struggled with his math work in the days afterward.

“It was tough for me to do high-level math,” Urschel said of the days following a concussion. “I really tried to, I really wanted to because there was a paper I had been working on that I was really proud of because it was going to be my first big solo-authored math paper, and I wanted to keep working on it to finish it, and I really couldn’t because I had a hard time thinking through things and visualizing things. Thankfully I got the paper done and I was really happy to have it accepted. So it all ended well, but at the time I was frustrated.”

Not wanting to feel that kind of frustration again was part of his decision, as was the fact that he isn’t as attracted to the millions of dollars he could earn in the NFL as some players are.

Having said all that, Urschel doesn’t want people using him as an example of why other players should walk away from football.

“I love the NFL, I love football and I wouldn’t trade my experiences for the world, and I do believe football is a great game, and I didn’t want to be, for lack of a better word, fodder for certain anti-football establishments,” Urschel said.

So there you have it: One of the smartest players in NFL history has a well-reasoned view of the topic, which doesn’t fit neatly into either a pro-football or anti-football narrative.

mmack66 says:
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Did you read the article or go straight to the comments section? The MIT math whiz and the lady that authored the 99% study said that it is “highly, highly unlikely” that a high percentage have CTE.

And that is why John Urschel has a PhD folks because he is extremely intelligent. This study was conducted with the desired conclusion already in place. Namely, Dr Ann Mckee selected volunteers who believed they had some form of brain damage and ran tests on their brains. Thus this study needs to be taken with a grain of salt. Urschel did not want any legal trouble so he said McKee’s findings were highly unlikely rather than completely false. This study only shows that is possible to acquire brain damage from repeated collisions involving the head. And quite frankly, that isn’t really newsworthy. Anyone knows that bashing or smacking your head into a surface is dangerous, even if you wear a helmet. Going into a burning building, firefighter suit or not is dangerous. And that folks is the main take away. Safety technology merely REDUCES your chances of injury but it DOES NOT PREVENT injury.

Did you read the article or go straight to the comments section? The MIT math whiz and the lady that authored the 99% study said that it is “highly, highly unlikely” that a high percentage have CTE.
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I read the article. What they actually said that it could be somewhere between 0% and 99%. No one will ever know until they come up with test they can perform on living people.

That said, repeated blows to the head through high school or earlier, through college, and on through the NFL, gives players a high chance of developing CTE.

I don’t know what the concussion numbers are (I don’t think anybody does at this point), but it’s probably something like smoking and cancer. The average person has something around one in 1300 chance of getting lung cancer. A smoker’s average is closer to one in 50. Most smokers don’t get lung cancer (around 49 out of 50), but their odds of getting it are MUCH higher than non-smokers to the point where people say, “smoking causes cancer,” even though a lot of the time it actually doesn’t. Something similar is going on with football and concussions. Even if something far less than a majority of players develop CTE, football and the impacts that occur in the game, are going to be found to increase the odds to the point where we attribute a cause and effect to it.

mmack66 says:
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They don’t even know if it’s repeated blows to the head that causes CTE or if its naturally occurring. They need to study a control group that represents normal demographics to further enhance their understanding.

My grandmother had early dementia and the depression that goes along with it… pretty sure she never played HS football. While cases like Seau, McMahon, etc are sad; those circumstances are not unique to only former football players.

magikskillz says:
September 13, 2017 at 1:54 pm
And that is why John Urschel has a PhD folks because he is extremely intelligent. This study was conducted with the desired conclusion already in place. Namely, Dr Ann Mckee selected volunteers who believed they had some form of brain damage and ran tests on their brains……

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I don’t think you read this article either that or you didn’t comprehend it. Dr. Mckee didn’t “select” volunteers they came to her. Urschel wasn’t even blaming her. He was simply pointing out that the likelyhood if most volunteers for this study to have sone sort of brain injury is already high because most people that feel ok don’t volunteer for these types of study. Even Dr. McKee said as much.

I don’t mean to downplay head trauma or CTE by any stretch, but the way that story was twisted was very misleading based upon the test samples. What they did would be similar to testing 100 smokers who have symptoms of emphysema, finding that 90 of them have emphysema and then saying 90% of smokers have emphysema. You just cannot do it that way. Again, I don’t mean to downplay this, be insensitive nor undermine how bad CTE can be, but you just can’t reach that conclusion based on that study.

That study was not meant to be applied categorically across all former NFL players. If that had been its intent, it would have been discredited from the outset.

Look, let common sense settle in here. The NFL used to allow head-slaps to offensive linemen by pass rushers, and helmet-to-helmet hits by defensive backs on receivers without batting an eyelash. For crying out loud, Darryl Stingley was paralyzed by one of those hits in a preseason game, and the NFL did absolutely nothing to stop them at that time. Go out to youtube and watch that hit, and realize that today, Jack Tatum would have been fined and suspended multiple games for the hit alone, let alone the result of it. Hits like that were both legal and common back then.

While there are many instances of players who have suffered brain damage who played back then, the reality of the situation is that the vast majority of them have not suffered noticeable effects.

I have no problems with Urschel retiring; he obviously has a great career awaiting him elsewhere that will expose him to far less danger. But to suggest his stance is nuanced is silly; it’s just common sense.

I’m not sure why some find it hard to believe that playing a violent collision sport could give you permanent brain damage. It’s not different than guys that are limping around with knee or back problems after they retire. The wear and tear after a football career is tough. However, NFL players also are in great shape, eat healthy and don’t suffer as frequently from many of the diseases that affect most of the population like heart disease.

So there is risk, but they are paid handsomely for taking that risk. Probably less risk than firemen take every day for a fraction of the reward.

nathanp2013 says:
September 13, 2017 at 2:15 pm
mmack66 says:
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They don’t even know if it’s repeated blows to the head that causes CTE or if its naturally occurring. They need to study a control group that represents normal demographics to further enhance their understanding.
My grandmother had early dementia and the depression that goes along with it… pretty sure she never played HS football. While cases like Seau, McMahon, etc are sad; those circumstances are not unique to only former football players.

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Do repeated blows to the knee cause permanent knee problems? Definitely. Since you can see it and feel it is easy to understand that.

It’s only logical that hitting your head over and over again would cause permanent damage at some point.

Genetics certainly plays a role, as it does with your physical durability, but taking hits is worse for your body than not taking hits.

logast says:
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Don’t mistake sensational misleading headlines written by gossip columnists and ESPN staffers as actual fact and data. Read the studies… the doctors and researchers themselves cited in the 99% study quite literally go on record by saying that their understanding of CTE is in its infancy and their study is narrowly scoped to look at deceased brains that they expected to find it in.

All trades carry risk with them,being in construction I have hurt myself and have been hurt by unfortunate circumstances several times.
Secretary’s get carpal tunnel and back problems and the list goes on.
The biggest difference is that the players only take that risk for an average of 3 years and get paid a lifetimes worth of wages for doing so.
I personally feel that they are well compensated for there risk especially considering they know what they are getting themselves into and aside from that most of these guys love football and most of what comes with it. After all there isn’t many occupations that you can go from a nobody to a superstar.

I wonder if he knows that being grossly overweight contributes to heart disease. Since we all learn that at a very young age, I’m curious to how he could let himself get so big and fat to plat offensive line.

bullcharger says:
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I entirely agree… getting hit in the head is not great for a brain. CTE is a difficult thing to sum up in 50 words.

What I’m saying that CTE, in the public eye, is the root disorder for a complex myriad of mental problems that occur in a large portion the general population whether they played football or not. Unfortunately, things like dementia, Alzheimer, memory loss, Parkinson, depression all exist in a large portion of the population. If a former player is depressed… it doesn’t mean that the have CTE. Many (but not all) of the former players that now have Alzheimer’s or dementia would have gotten with or without football

Lastly, I am saying that you can’t know the true impact of all of those hits until you find out if CTE exists in the general population… or if it is entirely unique to contact sports.

raidernation81601 says:
September 13, 2017 at 3:07 pm
All trades carry risk with them,being in construction I have hurt myself and have been hurt by unfortunate circumstances several times.
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Last time I checked playing football is not a trade. There’s no apprenticeship. A football player is not creating anything, building anything. They’re high level athletes who get paid to perform athletic feats. Being a former tradesman myself, I can honestly say my risks never consisted of running into other tradesmen at full speed, 45-60 times in a 3 hour time span. It’s not even apples and oranges, it’s apples and Pizza.

John Urschel is a smart, educated man that has lots of options when it comes to employment, so him quiting football was good move for his future. Kudos to him for not becoming a anti-football clown that’s trying to end the sport. He simply felt the game wasn’t for him anymore and retired without badmouthing the league. Much Respect.